Hyperlactation Syndrome

What is hyperlactation syndrome?

Hyperlactation syndrome, also known as breastfeeding (chestfeeding) oversupply, happens when a breastfeeding person produces more breast milk than their infant needs. If you have an overproduction of milk, the condition can affect you and your baby in different ways. Your provider or a lactation consultant can help you figure out ways to produce less milk, making breastfeeding a more comfortable experience for you and your baby.

How does my body produce milk?

Lactation begins during pregnancy, when your body begins to make milk. Once your baby is born, your milk production increases (your milk comes in). As your baby begins to eat regularly, your body typically adjusts the amount of milk you produce to match your baby’s needs.

How common is breast milk oversupply?

It’s hard to know how many people have breast milk oversupply, but the condition isn’t unusual. It typically occurs when your feeding or pumping schedule doesn’t match your baby’s feeding needs. 

What are the symptoms of breastfeeding oversupply? 

If you’re producing too much breast milk, you may notice certain symptoms in your breasts. You may experience:

• Breast engorgement.
• Breast pain (mastalgia).
• Breasts that don’t empty completely during feedings or feel full again soon after.
• Clogged milk ducts.
• Milk leaking frequently from your breasts.
• Nipple fissures.
• Nipple blebs.
• Vasospasm.

What is overactive milk ejection reflex (OMER)?

You may notice that your milk releases with force. This sudden release is overactive milk ejection reflex (OMER) or “fast letdown.” If you have OMER, your baby may have a hard time keeping up with the milk flow. They may sputter and gasp as they try to feed.

Does breastfeeding oversupply cause symptoms in my baby?

If you have hyperlactation, your baby may not want to latch on or may pull away from your nipple during feeding. You may notice during feedings that your baby:

• Arches their back or stiffens their body while nursing.
• Coughs, chokes or gulps while feeding.
• Cries or is restless during feedings.
• Gains too much weight or not enough.
• Produces poop (stool) that is explosive, green or foamy or has blood in their stool.
• Spits up often.

Can hyperlactation cause my baby to have an upset stomach?

When your baby breastfeeds, they take in:

• Foremilk: This watery milk, higher in carbohydrates (lactose) and lower in fat, flows at the beginning of a breastfeeding session.
• Hindmilk: This milk is higher in fat and flows at the end of a breastfeeding session.

When milk flows too forcefully or quickly, your baby may fill up on foremilk. The higher lactose content in foremilk can cause your baby to become gassy or pass loose stools. Your baby may also have abdominal pain. 

What causes breastmilk oversupply?

Breastmilk oversupply happens for different reasons. Sometimes, there’s no specific cause — your body may simply produce large amounts of milk, especially at first. This usually gets better if you only nurse or pump to meet your infant’s needs. Pumping more than your infant needs can cause breast milk oversupply.

What are the risk factors for hyperlactation syndrome?

Some breastfeeding parents naturally produce more milk due to their genetics. You may also be at greater risk for hyperlactation syndrome if you have hyperprolactinemia. Certain herbal supplements may also affect your milk supply.

How is hyperlactation syndrome diagnosed?

Your healthcare provider gathers information about you and your baby to diagnose hyperlactation syndrome. They may ask you about your:

• Baby’s feeding habits.
• Baby’s health.
• Breast symptoms.

What tests do providers use to diagnose hyperlactation syndrome?

Your provider can often diagnose hyperlactation syndrome after talking with you about your symptoms. People rarely need any additional workup.

How is hyperlactation syndrome treated?

Your healthcare provider may encourage you to follow your baby’s feeding demands instead of feeding on a set schedule. This helps your milk production adjust to your baby’s needs. Using a side-lying or laidback position for feeding can help slow how fast your milk flows so your baby can better handle your overactive milk ejection reflex.

How can I decrease my milk supply?

Talk to your healthcare provider about how to decrease milk supply. Sometimes, block feeding can help. You alternate breasts for certain time “blocks” (often three hours) as you feed your baby throughout the day and night. Ask your provider about the length of time you should use for each block.

Over time, sometimes as soon as 36 hours, feeding your baby from the same breast for two or more feedings helps reduce the overall stimulation to your breasts. Reduced stimulation helps decrease the volume of milk in each breast.

You can also gradually reduce pumping volumes over several days or weeks. Stopping pumping abruptly can lead to clogged ducts or mastitis, so work with your healthcare provider to gradually reduce how often or how much you’re pumping.

What medications do providers use to treat breast milk oversupply?

Talk to your healthcare provider about medications that may help decrease your milk supply.

Is hyperlactation syndrome preventable?

You can’t always prevent hyperlactation syndrome, but you can lower your risk by following your baby’s lead for feedings. Avoid pumping too often because the more you pump, the more milk you’ll produce.

What can I expect if I have breast milk oversupply?

Expect your breasts to be uncomfortable as your milk supply adjusts to your baby’s needs. Talk to your healthcare provider about ways to ease your discomfort that are safe for you and your baby.

How long will hyperlactation syndrome last?

Managing hyperlactation syndrome takes patience. Your milk supply typically adjusts to your baby’s needs over time. A lactation consultant can help you manage your baby’s breastfeeding schedule and symptoms of breast milk oversupply.

How do I take care of myself if I have breast milk oversupply?

Breastmilk oversupply can be stressful for you and your baby. Get as much sleep as you can and drink plenty of fluids so you don’t become dehydrated.

When should I see a healthcare provider?

See your healthcare provider if you have very painful breasts or flu-like symptoms. These could be signs of mastitis, which your provider can treat with antibiotics.

Take your baby to a healthcare provider if they have difficulty during breastfeeding or explosive stools.